There are 29,700,000 adult Americans currently affected by vision problems that if not detected and treated early, could lead to vision loss. And an estimated 12,000,000 school-age children, or one in four, suffer from vision problems or eye disease that, if not treated can affect learning and cause lifelong impairment. To address this problem, Prevent Blindness America, the nation's leading voluntary health organization dedicated solely to the prevention of blindness and preservation of sight, proposes the National Vision Preservation Initiative, a collaborative effort toward the development of an integrative approach to eye health promotion and vision loss prevention. Focusing on program development, implementation, evaluation, and integration, the goal of the National Vision Preservation Initiative is Intervention is to enhance the growing public health attention given to vision preservation. This project will involve multiple parties across four separate, yet integrated components. We have compiled a program and research team to guide this work, pulling from academia, public health, and our own network of affiliates. Participating organizations include: Duke Clinical Research Institute (DCRI), Johns Hopkins Bloomberg School of Public Health (JHBSPH), New York State Department of Health (NYSDOH), Prevent Blindness North Carolina (PBNC), Prevent Blindness Ohio (PBO), and Prevent Blindness Tri-State (PBTS). The research team will examine an adult screening program as implemented in Ohio community health centers and free clinics to determine its implications on vision health in the aging population. Working with the North Carolina Pediatric Society, screening programs within pediatric practices will be implemented and evaluated, while screening efforts in North Carolina schools are similarly examined. The New York State Department of Health and Prevent Blindness Tri-State will undertake a collaborative effort to integrate appropriate and effective vision preservation strategies into existing programs and functions within the health department and to promote public health strategies among community organizations and vision partners. And finally, the research team will enhance and expand existing data sources so that they can be used to track epidemiology of vision impairment and eye health related services utilization. To expand on this, an active registry will be developed, to include clinical and public health datasets and related tools that can be used to describe the epidemiology of vision impairment across the age spectrum or the utilization of vision care and eye health related services, including screening, diagnosis, treatment, rehabilitation, and preventive care.